Individual
MRS. MARY PATRICIA TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
16555 MANCHESTER RD, SUITE 110, WILDWOOD, MO 63040-1220
(636) 405-3155
(636) 405-3162
Mailing address
16555 MANCHESTER RD, SUITE 110, WILDWOOD, MO 63040-1220
(636) 405-3155
(636) 405-3162
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
066801
MO
Other
Enumeration date
05/25/2006
Last updated
07/21/2015
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